トランスキャセータ性大動脈弁置換と,その後の感染症性内心炎と,入院中の死亡との関連
Ander Regueiro1, Axel Linke2, Azeem Latib3
1Quebec Heart & Lung Institute, Laval University, Quebec City, Quebec, Canada.
JAMA
|September 14, 2016
まとめ
トランスキャテータ性大動脈弁置換 (TAVR) の後の感染症性内心炎は,若い年齢,男性性,糖尿病,大動脈吐と関連しています. TAVR関連の内臓炎の患者は,高い入院率と2年後の死亡率に直面しています.
科学分野:
- 心臓病科
- 感染症
- 医療機器
背景:
- トランスキャテーター大動脈弁置換手術 (TAVR) の後に感染性内心炎を発症した患者の臨床的特徴とアウトカムに関するデータは限られている.
- これらの要因を理解することは,TAVR手順の後の患者の管理と結果を改善するために不可欠です.
研究 の 目的:
- TAVR後に感染性心内炎を発症した患者の因子,臨床的特徴,アウトカムを決定する.
- TAVR集団における感染症性内心炎および関連死亡率の危険因子を特定する.
主な方法:
- TAVR後の感染症内膜炎は,TAVR後の感染性内膜炎を明らかにした患者に関するデータを,世界47のセンターから収集した.
- 2005年6月から2015年10月までの間,発生率,危険因子,病原菌,死亡率を中心にデータを収集した.
主要な成果:
- 感染性心内炎の発生率は,TAVR後の1人当たり1. 1%であった. 年齢の若さ,男性性,糖尿病,中度から重度の大動脈吐はリスク増加と関連していました.
- 最も一般的な病原菌は腸球菌と黄金球菌でした. 入院死亡率は36%で,2年後の死亡率は66. 7%であった.
- 病院での死亡率に関連する要因には,高いロジスティックEuroSCORE,心不全,急性腎臓損傷が含まれています.
結論:
- 年齢の若さ,男性性,糖尿病,残留性大動脈吐は,TAVR後の感染性内心炎の重要な危険因子です.
- TAVR後の感染性心内炎は,病院内および長期的な死亡率と関連しており,注意深いモニタリングと管理の必要性を強調しています.
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